Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Base Ensemble Extended Wear Testing	Form	New	Available
Firefighter Accountability Proximity Project NEON Proximity Unit	Form	New	Available
Acquisition 360 Survey	Form and Instruction	New	Repair queued
Seacoast WAMS User Feedback Questions	Form	New	Available
Form DHS Form 10093 STC Member Questionnaire	Form	New	Available
2015 CIS Ombudsman Annual Conference Feedback Form	Form	New	Repair queued
Form DHS Form 0041 JAC Survey	Form	New	Available
Form MCP-FM-NMC4-78 National Maritime Center Website Feedback	Form	New	Available
1601-0014_30 day FRN published.pdf	Supplementary Document	Uploaded 2015-03-19	Available
1601-0014_60 day FRN published.pdf	Supplementary Document	Uploaded 2015-03-19	Available
1601-0014_Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery A.docx	Supporting Statement A	Uploaded 2015-03-19	Available
Generic_Clearance_Submission_Template.doc	Supplementary Document	Uploaded 2014-10-31	Repair queued
Executive Order 12862.pdf	Supplementary Document	Uploaded 2014-10-31	Available
Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery Part B.doc	Supporting Statement B	Uploaded 2014-10-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
229977	Base Ensemble Extended Wear Testing	Form	New	Base Ensemble Extended Wear Testing
228711	Area Contingency Planning Survey	Other-	New
227387	Special Victim's Counsel Feedback	Other-Survey Monkey Instrument	New
225319	Firefighter Accountability Proximity Project NEON Proximity Unit	Form	New	n/a
222571	Acquisition 360 Survey	Form and Instruction	New	Acquisition 360 Survey
220073	Seacoast WAMS User Feedback Form	Form	New	Seacoast WAMS User Feedback Questions
219616	STC Los Angeles/Long Beach Regional Stakeholder Survey	Form	New	STC Member Questionnaire
218500	CIS Ombudsman 2015 Annual Conference Evaluation Form	Form	New	2015 CIS Ombudsman Annual Conference Feedback Form
218090	Customer Satisfaction for DHS Websites	Other-Mock-Up for Online Survey	New
217903	JAC AND JACCIS CUSTOMER SATISFACTION SURVEY	Form	New	JAC Survey
216997	National Maritime Center Customer Satisfaction Survey	Form	New	National Maritime Center Website Feedback
216332	DHS Pre-award and Debriefing Satisfaction Survey	Other-Survey	New

ICR Details

OMB Control No: 1601-0014	ICR Reference No: 201410-1601-003
Status: Historical Active	Previous ICR Reference No: 201201-1601-001
Agency/Subagency: DHS/OS	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/27/2015
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/31/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2018	36 Months From Approved	04/30/2015
Responses	200,000	0	45,098
Time Burden (Hours)	375,148	0	375,148
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 53435	09/09/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 74734	12/16/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 12

table that charts list of burden

IC Title	Form No.	Form Name
Acquisition 360 Survey	n/a	Acquisition 360 Survey
Area Contingency Planning Survey
Base Ensemble Extended Wear Testing	n/a	Base Ensemble Extended Wear Testing
CIS Ombudsman 2015 Annual Conference Evaluation Form	n/a	2015 CIS Ombudsman Annual Conference Feedback Form
Customer Satisfaction for DHS Websites
DHS Pre-award and Debriefing Satisfaction Survey
Firefighter Accountability Proximity Project NEON Proximity Unit	n/a	n/a
JAC AND JACCIS CUSTOMER SATISFACTION SURVEY	DHS Form 0041	JAC Survey
National Maritime Center Customer Satisfaction Survey	MCP-FM-NMC4-78	National Maritime Center Website Feedback
STC Los Angeles/Long Beach Regional Stakeholder Survey	DHS Form 10093	STC Member Questionnaire
Seacoast WAMS User Feedback Form	n/a	Seacoast WAMS User Feedback Questions
Special Victim's Counsel Feedback

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ICR Summary of Burden

table that charts list of burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	200,000	45,098	0	0	154,902	0
Annual Time Burden (Hours)	375,148	375,148	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $600,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/31/2014

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